Fibromyalgia (FM) affects women physically, mentally and socially, and carries a high cost to healthcare systems in Europe and elsewhere. Medications combined with cognitive behavioral therapies are known to relieve symptoms, as does physical fitness. Research is lacking, however, as to which exercises are most effective in decreasing both physical pain and the mental experience of pain in FM patients.

To this end, a research team from the Faculty of Sport Sciences at the University of Granada studied a group of FM women from southern Spain. Their results were included in a study entitled “Association of Physical Fitness With Pain in Women With Fibromyalgia: The al-Ándalus Project,” published in the journal Arthritis Care & Research.

The team assessed pain in 468 women using a questionnaire, a visual analog scale, and a bodily pain score. Researchers also used a scale to quantify mental factors associated with the experience of pain, such as catastrophizing pain (emotional response to pain) and self-efficacy expectations in coping with chronic pain. Physical fitness (aerobic fitness, muscle strength, flexibility, and motor agility) was assessed with standard performance-based tests.

The researchers observed that women with a higher physical fitness level consistently had lower levels of pain, lower pain-related catastrophizing, and higher chronic pain self-efficacy. Specifically, patients with high muscle strength plus high flexibility (combined effect) had the lowest levels of pain reported in this population. And women with high flexibility plus high aerobic fitness showed the best adjustment in psychological factors associated with the experience of pain, reporting superior catastrophizing and self-efficacy profiles. “Our exploratory analyses suggested that muscle strength and flexibility could be the fitness components most strongly associated with pain levels, while aerobic fitness and flexibility could be the fitness components most strongly associated with the psychological experience of pain,” the authors wrote in their report.

These data suggest that exercise should be a treatment option for women with FM, and according to the authors, are of “clinical and public health interest and will lead to future prospective studies aimed at investigating the potential of physical fitness to modify the natural course of the disease or to mediate treatment responses in women with FM.”